The Independent Inquiry into Child Sexual Abuse was established in 2015 to investigate “whether public bodies and other non-state institutions have taken seriously their responsibility to protect children from sexual abuse in England and Wales, and to make meaningful recommendations for change, to ensure that children now and in the future are better protected from sexual abuse” (Fisher C. et al., 2017).
The Truth Project was a core part of the Inquiry, aiming to “consider the experiences of survivors of child sexual abuse, providing opportunities to them to bear witness” (IICSA 2023). Between 2016 and 2021, over 6,000 adult victims and survivors shared their experiences with the Truth Project (Barker C. et al. 2023). Their testimonies were used to develop recommendations to prevent abuse in the future and improve institutional responses.
A trauma-informed approach was developed to support people taking part in the project. This included, for example, aiming to empower victims and survivors in their interactions with the Inquiry, and prioritising the safety and well-being of victims and survivors to prevent re-traumatisation. As part of this, participants could opt-in to a number of support sessions with counsellors and support workers, both before and after giving their testimony.
The Truth Project team wanted to know how successful they had been in meeting the needs of survivors and minimising harm. They also wanted specifically to know whether and how their trauma-informed approach had been helpful.
The Truth Project aimed to hear the testimonies of abuse survivors whilst offering trauma-informed support. The authors wanted to know whether they had successfully met the needs of the survivors and minimised harm.
Methods
The Truth Project participants were asked to complete a survey and rate the extent to which the Project had:
- enabled them to feel empowered
- treated them as an individual
- acted in a trustworthy way
- avoided retraumatisation, and
- created a safe environment for them.
They gave examples of each of the above, and some participants were also asked to take part in follow-up interviews to understand their experiences in more depth.
Results
Sixty-six participants completed the survey. Twelve of these were asked to take part in a follow-up interview, of whom seven did so.
Two of every five participants said that taking part in the Truth Project had caused them to re-experience trauma, whilst one in three participants said it had not caused them to re-experience trauma. The remaining participants did not answer this question. However, in further explaining their answers in more detail, a number of participants clarified that, whilst recounting their traumatic experiences had been distressing, and had in some cases led them to experience flashbacks and worsened mental health, this was usually short-term and seen as worth enduring for the chance to have their voices heard.
Participants mostly said that their experiences of the Truth Project had aligned with the principles of trauma-informed care. For instance, 85% felt the Project acknowledged their individual experience of abuse, 85% of participants reported finding the Project trustworthy, 79% of participants reported feeling empowered to make decisions, 68% reported feeling safe “all of the time” when engaging with the Project and 29% reported feeling safe “most of the time.” Examples of the types of experiences that had helped them feel this way included not needing to repeat their story to various people if they did not want to, clear communication and predictability, maintaining confidentiality, feeling heard and believed, feeling that they had choice and control over things like meeting dates and staff gender, and receiving empathy, support and a lack of judgement from staff.
The authors stated that the majority of negative experiences related to the subsequent referrals to the police rather than the Project itself, which participants found anxiety-provoking, distressing and disempowering. The authors also described the experiences of eleven people who said they needed longer-term support following taking part, and four who said they had experienced long-term negative effects from participation in terms of worsened mental health.
Participants reported that taking part in the Truth Project could be distressing, but this was usually short-term, and participants mostly felt acknowledged, empowered, safe, and able to trust the staff.
Conclusions
The authors concluded that:
most participants in the study sample found the trauma-informed approach addressed their needs and while there was some evidence of longer-term detrimental impacts, this was in a small minority of cases.
They attribute the success of the Project to its co-design by survivors, who were able to give detailed recommendations on how to meet participants’ needs and minimise harm. The authors argue that the success of the Project challenges the belief that asking survivors to share their stories is too damaging and distressing, showing instead that this can be done successfully if a safe and supportive environment is created where belief, validation and dignity are prioritised.
The Truth Project challenges the belief that asking survivors to share their stories is too damaging and distressing. This study demonstrates instead that this can be done successfully if a safe and supportive environment is created.
Strengths and limitations
The researchers were clear that they used a theory-driven approach to the analysis of the survey and interview responses, basing their analysis around the principles of the trauma-informed approach used in the Project. This was consistent with their objective to assess the extent to which the Project had met the aims of their trauma-informed model. Additionally, the authors described taking a number of steps to ensure their analysis was rigorous and trustworthy, including a reflexive audit trail of decision making, research supervision, illustrating their findings with quotes from participants, and analysing the full data set before developing themes.
Unfortunately, the researchers were only able to survey 66 of the over 6,000 people that took part in the Project, i.e. just over 1%. Participants were recruited specifically from the Inquiry’s Victims and Survivors Forum, a forum established by the Inquiry of people willing to be involved in advising various projects. So already these were a group of people who were motivated to be more actively involved in shaping the Inquiry than the rest of the Project participants. Therefore we cannot be sure that their experiences were representative of the rest of the participants.
For the follow-up interviews, it is a little hazy how researchers decided who to invite (people they thought would give “further rich data”), and they were not able to meet their aims of interviewing an ethnically diverse range of people.
The authors also acknowledge that the researchers were involved in implementing the Truth Project and therefore were not independent of it, which could have influenced their interpretation of survey and interview data. It would have been helpful to supplement this reflection with further reflexive insights, for example how the demographic characteristics, prior experiences and beliefs of the researchers could have influenced their interpretation of the data.
Only a tiny fraction of the Truth Project participants, just over 1%, were included in this research study, so we cannot be confident that their experiences reflect the broader picture.
Implications for practice
The findings challenge the idea that sharing testimonies about child sexual abuse is harmful for survivors. Instead, they suggest that taking part in child sexual abuse enquiries can potentially be part of the healing process for participants, through enabling them to feel empowered, safe, heard and believed, and that trauma-informed approaches can be a good way of achieving this. Further, survivor involvement in co-designing trauma-informed approaches was emphasised as important for their success.
However, whilst taking part in child sexual abuse inquiries can be meaningful and beneficial for victims, there is also a risk of distress and potential longer term negative consequences. Potential participants should be warned about these risks before they agree to take part and those designing inquiries should ensure appropriate follow up care is available.
Finally, the enquiry highlighted the contrasting lack of trauma-informed approach taken by organisations such as the police. Instead, survivors felt distressed and disempowered by their interactions with police. In reading this I was reminded of friends of mine who are abuse survivors, who have told me they would never go to the police as they could not cope with the distress entailed and do not trust that any positive outcomes would result. I am also reminded of the all too frequent accounts of survivors being disbelieved by police and the absolutely devastating and in some cases lethal consequences for their self-concept and mental health. The shameful statistics on the tiny proportion of rape allegations that result in a conviction also bear witness to the culture of disbelief and victim undermining that blights our criminal justice system (Hohl, K, 2022). The Truth Project was not perfect and nor did it succeed in achieving zero harm; nonetheless, organisations like the police have a lot to learn from its trauma-informed approach to survivor empowerment.
Trauma-informed enquiries can be part of the healing process for survivors of childhood sexual abuse. The police and criminal justice system have a lot to learn from this.
Statement of interests
None to declare.
Links
Primary paper
Barker, C., Ford, S., Eglinton, R., Quail, S., & Taggart, D. (2023). The truth project paper one—how did victims and survivors experience participation? Addressing epistemic relational inequality in the field of child sexual abuse. Frontiers in Psychiatry, 14, 1128451. https://www.frontiersin.org/articles/10.3389/fpsyt.2023.1128451/full
Daniel Taggart – Mental Health Provision for Adult Survivors of Child Sexual Abuse
Listen to one of the authors (Daniel Taggart) of this paper speaking on The Mental Elf podcast before his keynote talk at the #BIGSPD23 conference in Glasgow.
Look back at our live tweeting of Daniel Taggart’s keynote talk at #BIGSPD23.
Other references
Fisher C, Goldsmith A, Hurcombe R, Soares C. The impacts of child sexual abuse: a rapid evidence assessment. IICSA Research Team: Independent Inquiry into Child Sex Abuse. (2017) Available at: http://uobrep.openrepository.com/handle/10547/624859
Hohl, K. New scorecards show under 1% of reported rapes lead to conviction – criminologist explains why England’s justice system continues to fail. https://www.city.ac.uk/news-and-events/news/2022/04/new-scorecards-show-under-1-of-reported-rapes-lead-to-conviction-criminologist-explains-why-englands-justice-system-continues-to-fail
Independent Inquiry into Childhood Sexual Abuse. Terms of reference. (2023). Available at: https://www.iicsa.org.uk/about-us/terms-reference.
Photo credits
- Photo by Stephan Eickschen on Unsplash
- Photo by Priscilla Du Preez on Unsplash
- Photo by Matthew Waring on Unsplash
- Photo by Aaron Burden on Unsplash
